Provider Demographics
NPI:1194228478
Name:WONG, ABIGAIL YOONHEE (PA-C)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:YOONHEE
Last Name:WONG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 S GLEBE RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-1655
Mailing Address - Country:US
Mailing Address - Phone:703-521-0644
Mailing Address - Fax:703-521-9413
Practice Address - Street 1:46 S GLEBE RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204
Practice Address - Country:US
Practice Address - Phone:703-521-0644
Practice Address - Fax:703-521-9413
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110-006109363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant